Breastfeeding is free, my husband likes to say, the way kids are free: it doesn’t cost anything to conceive a child, but rearing one is a major investment. And although a woman’s body can produce breast milk for free, feeding a child that milk for months comes with a lot of associated costs.

In six months of exclusively breastfeeding my daughter, my husband and I have spent approximately $2,000 on products and services to make nursing and pumping breast milk easier and less uncomfortable. A year’s worth of formula costs between $1,200 and $2,000.

But public discussion of the economics of breastfeeding tends to focus on macroeconomic savings, such as how much would be saved in national and global healthcare costs if breastfeeding rates increased and women and children suffered lower rates of certain illnesses that breastfeeding seems to protect against. Last week, the Lancet published a special series discussing topics like how much would be added to national economies if more children had the higher IQs associated with breastfeeding.

That series, and similar pro-breastfeeding calls to action by the US surgeon general and other medical groups, don’t examine what breastfeeding costs individual women and families. Such cost studies are rare, though some on earnings have troubling findings – one found that women who breastfeed for six months or more have lower earnings for up to five years compared to moms who formula feed or breastfeed for shorter periods.

Instead, we start from the assumption that breastfeeding is free and formula is expensive. Why pay a premium for formula, the argument goes, when you can feed your child “liquid gold” for free?

Before my daughter was born, this argument made perfect sense to me. I had decided to breastfeed mostly because of the purported health benefits, not for financial reasons. But given all the costs associated with a new baby, it seemed like a nice perk that I could feed my daughter “the perfect food” for the cost of a few nursing bras.

How wrong I was.

About a third of the $2,000 we’ve spent so far went for products to make nursing and pumping more convenient – or, more accurately, less inconvenient: nursing bras and tops that flip down or pull aside for easier access; a nursing smock for modesty in public; reusable and disposable pads to keep milk from leaking at inopportune times; hands-free bras so I could work while pumping milk.

The rest was spent on healthcare and associated products to treat nursing pain and help my daughter feed efficiently enough to gain weight and thrive. These medical costs included visits to a doctor who specializes in breastfeeding; a minor surgical procedure on my daughter’s lip and tongue to help her latch better to my breast, intended both to help her get more milk and to reduce the pain and infections her latching problems caused me; medications and supplements; plus creams, nipple shields and special cooling packs to ease and treat said pain and infections.

Not all babies, of course, need lip and tongue-tie procedures, though the condition may be more commonly diagnosed in countries like the US and the UK as more women elect to breastfeed. But pain while nursing is far from rare, which is why lactation consultancy is a growing field.

The Affordable Care Act (ACA) mandates that insurance companies and Medicaid cover lactation support, a worthy provision for the many women who experience pain and other difficulties with nursing. But it doesn’t additional cover additional copays when doctors file separate claims billed as infant feeding problems, as my breastfeeding doctor and pediatrician both did when nursing troubles kept my daughter from gaining weight fast enough.

Note that I haven’t yet mentioned the cost of pumping milk. The ACA requires insurance companies to provide women who want to nurse with a free pump, and I was delighted when mine, complete with freezer storage bags and a slick black tote, arrived shortly before my daughter’s birth.

What I didn’t realize was that the ACA doesn’t require insurance to offer a choice of pump brands, or to provide accessories to fit differently sized breasts, even though properly fitting attachments are crucial to prevent pain and maximize milk pumped.

The pump my company provided caused abrasions and bruising, even after I bought specialized inserts. So for the past three months, I’ve been shelling out $56 a month to rent a hospital-grade pump that’s more more efficient and less painful.

Considering all this, it’s no wonder the breast pump market is expected to reach $1bn in the US by 2020 – and the breastfeeding and pumping accessories market to reach $2bn – according to Lactivism, Courtney Jung’s recent book critiquing the breastfeeding advocacy industrial complex and claiming that its many supposed health benefits are exaggerated.

To be fair, $3bn is still less money than the US spends on formula annually. But pumps and accessories aren’t the only expenses for women like me, who are convinced that breastfeeding is the only acceptable feeding option even while encountering serial difficulties.

Despite the pain, cost and inconvenience, I’m still pumping milk and nursing my daughter at six months, and I plan to continue until she’s a year old. I enjoy cuddling and bonding with her while nursing and suspect breast milk does confer health benefits, even if they may have been overstated.

That is, I still think “breast is best”. But it’s definitely not free.